| Ebullience Counseling | |
|
501 Avalon Way Ste D Brandon MS 39047-7500 | |
| (601) 874-3340 | |
| (601) 494-3241 |
| Full Name | Ebullience Counseling |
|---|---|
| Speciality | Counselor - Professional |
| Location | 501 Avalon Way Ste D, Brandon, Mississippi |
| Authorized Official Name and Position | Erica Ashley Brumfield (OWNER, OPERATOR) |
| Authorized Official Contact | 6018743340 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebullience Counseling Po Box 68375 Jackson MS 39286-8375 Ph: (601) 874-3340 | Ebullience Counseling 501 Avalon Way Ste D Brandon MS 39047-7500 Ph: (601) 874-3340 |
| NPI Number | 1326866120 |
|---|---|
| Provider Enumeration Date | 09/30/2024 |
| Last Update Date | 09/30/2024 |
| Certification Date | 09/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326866120 | NPI | - | NPPES |
| 009356703 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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